mediastinal lymph node involvement

Can anyone give me advice on how to treat positive lymph nodes in my chest area?  I was diagnosed with BC in 2006 and had ACT plus radiation.  Had a recurrence along the scar line about a year later.  Had that removed surgically and started doing Herceptin and Aromasin.  Scans showed some lymph node involvement in chest areas.  Past two scans showed improvements (some lymph nodes disappeared and others remained stable). Most recent scan (9/25) showed "increased metabolic activity" but no new sites.  My husband and I are meeting with my onc. today to discuss options.  I'm just devastated by this.....can't stop crying.  There are so many drugs out there; how do I find the right treatment.  The ACT almost killed me the first time around.  I can't understand why the Herceptin seemed to be working and now it's not.  Please help!

Please stop crying. We have to stay positive in our situation.

I hope my experience can help you. The scan does not show if it’s cancer or not. It shows enlarged lymph nodes, point. You need to have some kind of biopsy to check them out.

I was in similar situation last year (May 08 to be exact). I had chest CT that showed 6 or 7 enlarged nodes (one was almost 7sm), my oncologist said that my BC is coming back, but he was really smart to send me to see chest surgeon, lung doctor, and gastroenterologist before any treatment assigned to discuss biopsy options. They had to decide how to reach one of the enlarged nodes.

All three doctors said that they can reach at least one node, but gastroscopy was easier comparing to chest surgery for example. The gastroscopy biopsy showed that it was not cancer. It was sarcoidosis, Sarcoidosis is not a gift too, but everything is better than cancer. So I did not get any additional treatment, visited lung doctor every 2month, had chest XR before I visited him. Nodes were becoming smaller and smaller. After several visits the doctor said that I don’t need to see him anymore.

My personal opinion (my oncologist disagrees, but he does not have other answer why) that enlarging of the lymph nodes was my body reaction on chemotherapy. Another oncologist who I saw for a second opinion said that he had a similar case before:  cancer in connection with sarcoidosis.

BTW, I have never had any lung problem before.

Good luck. Stay positive and enjoy every day of your life.

Please let me know what your doctor says.

Elena

 

Dear Elena,

Thank you for your response and kind words of encouragement.  After a long meeting with my onc. yesterday he is pretty sure that this is disease progression.  Some new lymph nodes have showed positive in the same region.  But, he is very optimistic that I have lots of options and many different treatment plans to choose from.  He thinks that a different endocrine therapy might be worth a try, or some different chemo type drugs.  He named Lapatinib and Xeloda in combination, or Navolbine (?) or an injection with Fasodex (sp?) plus Herceptin.  I am in the process of getting some additional opinions.  I feel a little better, but I'm still discouraged.  When this showed up last year a thoracic surgeon was able to get a bit of tissue from one of the nodes in my chest and it was positive.  My onc. suggested that it might be worth getting additional tissue from one of the more easily accessible nodes just to verify the ER/PR/HER status.....mine has flipped from negative to positive to negative in the past two years. 

I'm happy to read that yours were negative.  Keep the faith and I'll keep you in my prayers!

Legalbeagle